A Notice of Claim form is completed and submitted to the Second Injury
Board at the address provided at the top of the form. Enclose as much
of the information requested on the form as possible when filing the claim.
At the least, submit the first report of injury with the Notice of Claim
form. Completed forms can be mailed, faxed to (225) 219-5968, or emailed
to owcsib@lwc.la.gov.

The employer, or if insured, his insurer, must file a Notice of Claim
form within 52 weeks after the first payment of any benefit (indemnity
or medical) by mailing, faxing, or emailing the form to the Second Injury
Board.

The Notice of Claim (PDF)
form can be obtained by downloading it from this site, or by calling the
Second Injury Board at (800) 201-2493, or by sending an email to owcsib@lwc.la.gov.

A self-insured employer, the employer's insurance company, a third party
administrator responsible for administering the employer's workers' compensation
claims, or an attorney representing either the employer or the employer's
insurance company can file a claim.

The employee must have a pre-existing permanent partial disability
as listed and defined by R.S.23:1378(F)
that is an obstacle or hindrance in obtaining employment.

The employer must establish that they had actual knowledge of the
employee's pre-existing permanent partial disability prior to the subsequent
injury.

The employee must sustain a subsequent (occupational) injury that
results in liability for workers' compensation.

The subsequent injury would not have occurred but for the pre-existing
permanent partial disability.

The disability is greater than would have resulted had the pre-existing
permanent disability not been present, and the employer had been required
to pay compensation for the greater disability.

The employer, or if insured, his insurer, must file a Notice
of Claim (PDF) form within 52 weeks after the first payment of any benefit
(indemnity or medical) by mailing, faxing or emailing the form to the
Second Injury Board.

No. The employee must sustain a subsequent (occupational) injury that
results in liability for workers' compensation benefits occurring after
the employer is made aware of an employee's pre-existing permanent partial
disability and all the pre-requisites are met.

Every property and casualty insurer, individual self-insurer and group
of self-insurance funds that have paid workers' compensation benefits
make an annual payment (assessment) to the fund. The assessment rate is
based on a percentage of the total benefits paid in the prior calendar
year.

For dates of accident before July 1, 2004 & on/after July 1, 2009, but before July 1, 2010:INDEMNITY TTD/SEB/PTD After the first 104 weeks of payment of benefits
Death benefits after the first 175 weeks of payment of benefits

MEDICAL
50% of all reasonable and necessary medical expenses actually paid which exceed $5,000.00, but no less than $10,000.00
100% of all reasonable and necessary medical expenses actually paid which exceed $10,000.00

On/after July 1, 2004 & before July 1, 2009: INDEMNITY
After the first 130 weeks of payment of benefits

On/after July 1, 2010 & before July 1, 2015: INDEMNITY
After the first 104 weeks of indemnity

MEDICAL
100% of all reasonable and necessary medical expenses actually paid which exceed $25,000.00, including reasonable and necessary Vocational Rehabilitation expenses, if such expenses are directly related to services provided in the actual retention or reemployment of

Reimbursement requests are processed in the order that they are received
in the office. Prior to any payments being made, Board approval must be
obtained. The Second Injury Board meets on the first Thursday of each
month. You may use the following link to view
the current month's agenda.

In the past, all reimbursements have been made by check. Now, Electronic
Fund Transfer is available. To make application for Electronic Fund
Transfer, download the form from this site and return with the necessary
information to the Second Injury Board.

Yes. An appeal must be filed within 30 days from the receipt of the Board's
decision. Appeals are taken to the 19th Judicial District Court, Parish
of East Baton Rouge, or the parish where the accident occurred.

To obtain the status of an existing claim, you can contact the Second
Injury Board by telephone, fax, or email. You can also view individual
reimbursement data by applying for access to the new SIB
Claims Interactive secure site. Contact owcsib@lwc.la.gov
for details.

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This page was last updated on January 11, 2018.